58
Treatment
6.5.6.2. Surveillance After AAA Repair
COR LOE
Recommendations
1 B-NR 1. In patients with AAA treated with EVAR, baseline
surveillance imaging with CT is recommended at 1 month
postoperatively. If there is no evidence of endoleak or sac
enlargement, continued surveillance with duplex ultrasound
at 12 months and then annually thereafter is recommended.
2a C-LD 2. In patients with AAA treated with EVAR who are undergoing
annual surveillance imaging duplex ultrasound, additional
cross-sectional imaging with CT or MRI of the abdomen and
pelvis every 5 years postoperatively is reasonable.
2a C-LD 3. In patients with AAA treated with EVAR and abnormal findings
(Table 21) on any surveillance duplex ultrasound, additional
cross-sectional imaging with CT or MRI is reasonable.
2a C-LD 4. In patients with AAA treated with complex EVAR, a modified
surveillance imaging plan that combines cross-sectional imaging
and duplex ultrasound of target vessels is reasonable.
2a C-LD 5. In patients with AAA who have undergone open repair,
surveillance imaging with CT or MRI of the abdominopelvic
aorta within 1 year postoperatively and then every 5 years
thereafter is reasonable.
Table 21. Abnormal Findings on Duplex Imaging After EVAR
That Should Prompt Additional Imaging
Aneurysm sac enlargement
Any endoleak
Stent gra fracture
Stent gra migration
Stent gra separation